A preventative approach to public services

Whoever wins the general election will be unable to deliver high-performing public services – and keep taxes and debt at sustainable levels – unless it commits to a prevention strategy that limits the rising tide in demand for acute services like hospitals and prisons. 

Published with UK Youth, the report sets out how the next government can use the opportunity of a new parliament to shift to a preventative approach to public services that seeks to address and manage citizens’ problems before they reach crisis point. This would reap financial and political benefits by helping tackle the crises in the NHS, criminal justice, youth services and beyond – and lead to happier and healthier lives for millions.

The report, which is based on an evidence review,  expert interviews, and a high-level roundtable with current and former senior policy makers from the centre of government, departments, local government, the NHS and wider public sector, finds a strong case for prevention. There is good evidence, for example, that investment in benefits, primary care, public health, youth work, and Sure Start children’s centres, among other services and programmes, all deliver benefits both in improved lives and in monetary terms.

But the report also finds prevention has not been prioritised in recent years. Since 2010, and across a range of services, political attention – and funding – has flowed away from prevention and towards acute services. For example, preventative local authority spending on services like youth clubs and children’s centres was cut by more than three-quarters (77.9%) between 2009/10 and 2022/23, while acute spending on looked after children and safeguarding services rose by more than half (58.1%) over the same period.

With the Conservative government putting prevention at the centre of the public sector productivity plans and Labour calling for “a ‘prevention first’ revolution”, the IfG and UK Youth report shows how a government serious about prevention could overcome historic barriers – short-term priorities, a centralised approach and siloed budgets – and sets out a five-step plan to deliver a more preventative approach.

1. Make prevention a political priority with ministers and other politicians needing to show leadership if they want to reap the benefits. 
2. Embed prevention into the spending framework, ringfencing spending on prevention, publishing a cross-government prevention strategy and funding thorough evaluations of preventative spending.
3. Embed prevention into the government’s performance framework, track progress against those metrics and be honest about successes and failures. 
4. Support local areas to spend preventative budgets how they see fit and remove central-government imposed barriers – like short-term funding pots – to innovation. 
5. Create a more effective accountability and learning system for local areas.